Abstract 2793: Increasing Levels of Hemoglobin A1C are associated with the Presence of Mixed Coronary Plaques in Asymptomatic Individuals without Diabetes Mellitus
Objective: Previous studies have demonstrated an association between high-normal glucose levels and coronary atherosclerosis. The objective of this investigation is to study the association between levels of hemoglobin A1C (HbA1c) in asymptomatic individuals without diabetes mellitus (DM) and coronary plaque sub-type.
Methods: The study population consisted of 1043 asymptomatic Korean subjects without DM who underwent 64-slice cardiac computed tomography angiography (CCTA) as part of a health screening evaluation. We excluded 128 individuals with known history of DM and/or fasting glucose ≥ 126 mg/dl. We analyzed plaque characteristics on a per-segment basis according to the modified AHA classification. Plaques occupied by calcified tissue more than 50% of the plaque area were classified as calcified, with <50% calcium as mixed, and plaques without any calcium were classified as non-calcified. The relationship of burden of coronary plaque-subtypes with increasing HbA1c (increasing tertiles) was assessed in multivariable linear and logistic regression analysis after adjusting for traditional cardiovascular risk factors.
Results: The final study population consisted of non-diabetic 915 participants (mean age: 49±9 years, 61% males) with 10% and 9% had 1 and ≥2 segments with any coronary plaques. Unadjusted analysis demonstrated a positive association between increasing levels of hemoglobin A1c and the number of coronary segments with mixed plaques (p < 0.0001). The table⇓ illustrates that the association persisted even when traditional risk factors were taken into account, whereas no such relationship was found with burden of non-calcified or calcified plaque.
Conclusion: Increasing levels of hemoglobin HbA1c are associated with the presence of mixed coronary plaques in asymptomatic subjects without DM. Further studies are needed to establish if individuals with this laboratory and coronary imaging profile have worse cardiovascular outcomes.